


Watson's War

by Boton



Category: Sherlock (TV)
Genre: Epic Bromance, Gen, Homage to MASH, Hurt/Comfort, Injured Sherlock, John is a Very Good Doctor, Kink Meme, Male Friendship, Medical Jargon, Medical Procedures, Medical Trauma, emergency surgery
Language: English
Status: Completed
Published: 2015-04-07
Updated: 2015-04-07
Packaged: 2018-03-21 18:42:05
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 2,123
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/3702201
Author URL: https://archiveofourown.org/users/Boton/pseuds/Boton
Summary: <blockquote class="userstuff">
              <p>Written for a prompt on the Kink Meme that read, in part:</p><p>Any situation where John performs some serious surgery on Sherlock, on his own.</p><p>Maybe Sherlock is seriously wounded, has an internal bleeding, an organ failure, a ruptured appendix. Maybe it happens when John is at work and Sherlock barely manages to get to him (of course he'd do it instead of going to hospital/calling an ambulance). At this point waiting for about 20 minutes until an ambulance arrives is absolutely ruled out, so John immediately starts working....Still it's not exactly ideal, but John is used to performing surgeries in much worse circumstances. And maybe some tools they have would be his second choice or he even has to improvise, not finding what he really needs....</p><p>Anyway, he performs the surgery, saves Sherlock's life and keeps him stable until an ambulance arrives.</p><p>Platonic johnlock or pre-relationship is preferable.</p><p>Rated T for mild language, mentions of blood, and medical procedures.</p>
            </blockquote>





	Watson's War

**Author's Note:**

> Disclaimer: Sherlock Holmes and his universe are the creation of Sir Arthur Conan Doyle. Sherlock is the creation of the BBC and its partners, and of co-creators Steven Moffat and Mark Gatiss. This work is for my pleasure and that of my readers; I am not profiting from the intellectual property of those creators listed above.
> 
> OP, I didn't wind up using Sarah Sawyer and the surgery in this, and I don't have Sherlock going back to John for follow-up as you wish, but I hope you like it anyway!

“I told the daft bugger he was along to solve the crime, not apprehend the suspect.”

The voice of Greg Lestrade floated up the stairs to 221B as John Watson came downstairs to the lounge. John had just gotten off work from the surgery and was looking forward to a nice bit of alone time since Sherlock was out with Lestrade on a case. He sighed deeply.

It wasn’t that John didn’t want to be with his flatmate; it was that, like anyone who shared living quarters, John looked forward to the occasional evening alone. He liked watching what he wanted on the telly without Sherlock shouting out the flaws in the plot, or ordering what he wanted for take-away without knowing that he’d probably just watch Sherlock pick at his, especially if a case were on. When Sherlock texted earlier in the day to say that Lestrade had a case for them, John felt both guilty and relieved to text back that he was too busy at the surgery to leave. Maybe this would give him a chance for a quiet evening in.

But that was apparently not to be. John turned to see Lestrade hauling Sherlock up the stairs, Sherlock’s arm looped over Lestrade’s shoulder and his appearance disheveled. Sherlock’s usually-neat scarf had come out of it’s perfect knot and was hanging unevenly around his neck, which was showing signs of abrasions and the early stages of bruising. Sherlock’s voice was weak and raspy, but he managed to make his feelings clear.

“Obviously, you needed help, Detective Inspector,” Sherlock half-whispered. “And there was no reason why I shouldn’t participate in taking the suspect in.”

“Yeah, other than the fact that he grabbed you by that insane scarf you insist on wearing and nearly choked you to death,” Lestrade said darkly, pulling off Sherlock’s coat and scarf as he deposited him in his chair. “Thought he was going to break your neck once he got hands on you. And then you refuse to go to A&E. I’m starting to question your ability to use logic, you know.”

Sherlock’s eyes shot daggers at Lestrade as he shrugged out of his jacket. “There is nothing wrong with me that requires the A&E John is perfectly capable of providing any medical care I might need,” Sherlock said, his voice now picking up a disturbing wheeze.

John sighed and walked over to Sherlock, crouching down in front of him and starting to gently palpate his neck. “Greg, will you run up to my bedroom and get my bag? It’s under the head of the bed on the side nearest the door,” he said over his shoulder, Lestrade turning to run the errand. “And you,” he said, turning back to Sherlock, “have to realize that, for all your knowledge, you are not a medic. You can’t properly diagnose injuries, particularly on yourself. And even if you do guess right,” he said, holding up a hand to stop Sherlock from protesting, “I don’t always have everything I need to treat you. Just because I have the training doesn’t mean I have the supplies.”

Sherlock was uncharacteristically silent after that, and John thought for a moment that he had succeeded in winning a fight for once. But, a second or two later, he looked into Sherlock’s eyes and saw panic.

The detective’s chest muscles were clearly trying to heave to bring in air as his hands floated impotently at about chest level, pantomiming an effort to scrabble at his own throat but failing in the attempt.

“John!” he wheezed, the word so faint that John could barely hear it. John reflexively eased Sherlock back in the chair and grabbed for the bag that Lestrade was putting at his feet.

“Hell!” John swore, grabbing a pen torch and attempting to look down Sherlock’s throat. “The tissues are completely swollen in here. He’s not getting any air. Greg, help me get him to the floor.”

The two men helped Sherlock down to the carpet of the lounge, with Sherlock clearly just barely holding onto consciousness, the wildness in his eyes dimming as the lack of oxygen took over. John tipped Sherlock’s head back and attempted to look again down his throat. “Damn. ‘Can’t intubate; can’t ventilate,’” he said. “Not that I could intubate anyway, even if his airway wasn’t swollen shut. I don’t have any of the equipment.” 

Sitting on his knees, an unresponsive patient in front of him, John was transported for a moment back to Afghanistan. He’d dealt with worse situations in worse places, that’s for sure. There’d been more than one young soldier wounded in the head or neck, wheezing his last breath as tissues swelled shut, waiting for John to secure an airway stable enough for transport. But that was cold comfort when confronted with his flatmate lying unconscious before him in the lounge of his own flat, lips turning slightly cyanotic.

Greg had pulled the few available lamps over to illuminate John’s workspace, and he whipped out his phone and ordered an ambulance to come to 221B Baker Street.

“They’ll be here in 10 minutes, John. Fifteen, tops,” Lestrade said. “You know London ambulances are pretty quick.”

“Not quick enough,” John said darkly, snapping back from his memory of Afghanistan. “We’ve got less than five minutes to get his brain some oxygen before he has irreversible damage.” John ran his hands through his hair, then sat back on his heels in decision while reaching for his bag. “I need you to help me crike him.”

“Do what?” Lestrade asked.

“We’re going to perform a cricothyroidotomy,” John said, snapping on gloves and handing a pair to Lestrade. We’re going to cut in through his throat and put in a tube he can draw air through. It looks like the swelling is higher than that, so he should be able to breathe until the paramedics can get him to hospital.”

John rummaged through the bag and came out with packages holding a sterilized scalpel, a cannula, gauze, and a betadine wipe. “Open his shirt down to the chest and clean his neck with this,” John said, handing the betadine wipe to Lestrade. “This isn’t ideal, but it might save this idiot’s brain.”

Sherlock’s brain. Of all the things to be at risk, this was the one that would hurt him the most. Sherlock would still be Sherlock with a missing limb, or with paralysis, or with any number of chronic conditions, but take away Sherlock’s brain and Sherlock was gone. He would never want to live like that; to be honest, John didn’t know if he could stand to see it. So much of what made Sherlock his best friend was trapped in that mass of grey matter, held so tenuously to life by a network of vessels and fed by a pair of lungs. The thought made John’s breath catch in his own throat.

Lestrade had finished cleaning Sherlock’s neck, so John bent to work. With his non-dominant hand, he found Sherlock’s Adam’s apple and the notch at the base of his neck. Putting a finger on each, he took the scalpel and looked up at Lestrade.

“I’m going to cut through the tissue here and then enlarge the opening so I can insert a cannula. I need you to take the gauze and keep wiping the blood so I can see what I’m doing.”

“Right,” said Lestrade. To the man’s credit, he acted like he assisted in emergency surgery on the floor of his friends’ flat every day of the week.

John gently stretched the skin between his fingers and began to cut, making a vertical incision that allowed him to see the cricothyroid membrane The blood welled up to either side, and Lestrade moved in smoothly to wipe it away. Sherlock remained motionless; John was relieved for his unconsciousness, because this would be painful were he awake.

“OK, now, I need you to take your fingers and gently hold the sides of the incision apart,” John instructed Lestrade. When he had done so, John took the scalpel again and cut and widened a hole through the membrane . He took the cannula from its wrappings and worked it into the hole as Lestrade wiped away the bleeding. John reached over to help Lestrade allow the initial incision to ease shut, the tissue closing around the tube and blood coursing slowly down Sherlock’s neck to his shirt collar and onto the floor. John attached an Ambu bag to the cannula and instructed Lestrade how to bag, one second for a “inhale” and four seconds for a natural “exhalation.” 

Just then, Sherlock’s eye’s opened, confusion filling them as he tried to process the unfamiliar position on the floor, John and Lestrade’s worried looks, and the frankly bizarre feeling of breathing through a tube in his own neck.

John started packing the wound with gauze as Lestrade put a preemptive hand on Sherlock’s shoulder. “Don’t move, mate. John’s taking care of you, just as you said, but you can’t budge.”

John leaned forward for eye contact with Sherlock. “Your throat was swollen shut from your injuries, so right now we’re helping you breathe through a tube in your neck. I know it feels strange and probably hurts quite a bit, but you’ll be fine,” he told him. What he saw in return brought a prickle of tears to the back of his eyes.

Sherlock looked up at him with a mixture of pain and absolute trust. John hadn’t seen that look on a man’s face since Afghanistan. It always affected him then, but now it shook him to the core.

In med school, he mused, they taught you how to maintain a distance. The white coat, the scrubs, the royal “we” (“How are we doing today?”), and even the protective gloves all served the purpose of creating a barrier between physician and patient. 

It wasn’t meant to be cruel. If a doctor became too involved with every patient, he would lose a piece of himself with every case, eroding until there was nothing left. For a doctor to be effective, he had to protect himself, emotionally as well as physically.

That all seemed to disappear when you were kneeling in sand or standing in an aid station, wearing fatigues and looking down at a young soldier who was frightened and in pain and who trusted you completely, John mused. Whether you wanted to or not, you took a piece of every one of those cases home with you, and you had to figure out a way to let them make you stronger instead of tearing you apart.

But seeing your best friend look up at you with that same expression, hurting but with absolute faith that you would be able to help him through, that…well, that, John thought, was a kind of gift. That was a bond that very few people shared with one another. That was a permanent tie with the other person that couldn’t be severed, no matter what. It was, in some ways, stronger than blood and stronger than family; it was a bond built of shared experience and understanding. As long as they lived, John and Sherlock would share this moment of life and death and pain and relief with only each other, and no one else would be able to understand how deep that link went.

John continued to wrap Sherlock’s wound, anchoring the cannula with tape and securing the bandaging for transport while he kept an eye on Lestrade’s bagging technique. Occasionally, he rubbed Sherlock’s shoulder or forearm, reassuring him. “You’re going to be OK, mate. The ambulance will be here soon, and we’ll get you all sorted.” Sherlock kept his eyes pinned to John, following his every motion, using him as a life raft to keep him afloat.

“John, they’re here,” said Lestrade, gesturing to the door where the paramedics were coming in. John glanced at his watch. Nine minutes; not bad. Pretty good for a London ambulance; at least five minutes too long to preserve the unique spark that was Sherlock Holmes.

John handed Sherlock off to the paramedics, rapidly giving the salient information about injury and treatment, and helping them position him on the trolley and get him covered with a blanket before strapping him in. As the trolley started to move, Sherlock’s hand darted out to grab the edge of John’s rolled sleeve, and he looked at John with a question in his eyes.

“Yeah, of course I’m coming with you in the ambulance. Gotta make sure you’re OK, don’t I?” John said.

Sherlock relaxed slightly onto the thin mattress but kept ahold of John. Some replies didn’t need words to be heard loud and clear.

**Author's Note:**

> When I was a child, my favorite show was MASH, which I watched obsessively in reruns. This made me the only third grader on the block who knew what an abdominal aortic aneurysm was and who wanted to discuss it at dinner. (Sorry, Mom and Dad!)
> 
> One of my favorite episodes was “Mulcahy’s War,” in which Father Mulcahy performs a tracheotomy in the field on a soldier using a Tom Mix pocket knife and the tube from an eye dropper. I took inspiration from this for this piece, and for the title. 
> 
> Based on an article in the British Journal of Hospital Medicine (December 2009, Vol. 70, No. 12, p. M186-M188), I made a layman’s guess that John would be more likely to perform a cricothyroidotomy in an emergency. It is from this article that I get the procedure, as well as the saying, “Can’t intubate; can’t ventilate.” Obviously, any medical errors belong to me and should be written off to the miracles of “TV (or fan fic) medicine” rather than being ascribed to the medical journal.


End file.
